SAGINAW TRANSIT AUTHORITY REGIONAL SERVICES

Transcription

1 SAGINAW TRANSIT AUTHORITY REGIONAL SERVICES APPLICATION FOR EMPLOYMENT We appreciate your interest in working at Saginaw Transit Authority Regional Services (STARS)! We are an equal opportunity employer and do not discriminate against otherwise qualified applicants on the basis of race, color, creed, religion, ancestry, age, sex, marital status, national origin, disability, handicap, veteran status, or any other protected class. This application was designed for use by persons applying for various types of positions Bus Operators, Professional, Technical, Clerical, Administrative, etc. Please answer ALL questions that apply. PLEASE PRINT. Date Position Applied For: Name Last First Middle address Street Apartment Number City State Zip Telephone Number ( ) Cell Phone Number ( ) Are you legally authorized to work in the United States? Yes No (If offered employment, you will be required to provide documentation to verify eligibility) Are you 18 years old or older? Yes No - If no, and offered employment can you furnish a work permit? Yes No Have you worked for STARS before? Yes No If yes, give dates & position(s) held Have you ever pled guilty or no contest to, or been convicted of a serious misdemeanor or felony? Yes No (Answering yes to this question does not constitute an automatic bar to employment, other factors will be taken into account.) If yes, please give date(s) and details: Can you perform the essential functions of the job, with or without accommodation, for which you are applying? Yes No DRIVER S LICENSE INFORMATION Do you currently hold a valid driver license? Yes No If no, please explain: State of License: Driver License #: Expiration Date: Do you have a current CDL? Yes No Expiration Date: Has your driver license, permit, or driving privilege ever been denied, suspended, or revoked? Yes No If yes, please explain: Have you ever been issued a probationary license, occupational license, or other restricted license? Yes No Have you ever been convicted for driving under the influence of alcohol, narcotic drugs, amphetamines, or derivatives thereof; and/or during the last three (3) years forfeited bond for any traffic violation, other than parking (applicants need not disclose expunged and sealed convictions)? Yes No, If yes, explain: Application for Employment Page 1 of Johnson Street

2 AVAILABILITY On what date would you be available to start work? Are you available for work: Full-Time Part-Time Shift Work Temporary How many hours can you work weekly? Are you able to work weekends? Yes No Are you available to work nights? Yes No Do you have access to transportation? Yes No EDUCATION AND TRAINING Type of Name of of Did You Graduate Type of Degree Number of Years Attended High College Graduate Technical/ Trade Other List awards, scholarships, honors received (includes publications, inventions, technical awards, etc.) List professional certifications, licenses, or designations, and dates received Application for Employment Page 2 of Johnson Street

3 EMPLOYMENT HISTORY This portion of the application must be completed even if a resume is submitted. Starting with the most recent employer, list full-time and part-time jobs, summer or volunteer work during the last 10 years. Include periods of military service, selfemployment, and unemployment. Please leave no unexplained gaps. Attach separate sheets if necessary. 1 Present or Past Employer Telephone # ( ) 2 Previous Employer Telephone # ( ) Application for Employment Page 3 of Johnson Street

4 EMPLOYMENT HISTORY, CONTINUED This portion of the application must be completed even if a resume is submitted. Starting with the most recent employer, list full-time and part-time jobs, summer or volunteer work during the last 10 years. Include periods of military service, self-employment, and unemployment. Please leave no unexplained gaps. Attach separate sheets if necessary. 3 Previous Employer Telephone # ( ) REFERENCES Please list at least three (3) references, not related to you, whom you have known for at least one (1) year. Name Company (Street, City, State) Phone Number Relationship Application for Employment Page 4 of Johnson Street

5 Applicants Certification and Agreement (Please read the following carefully and sign below) I hereby declare that the information provided by me in this Application for Employment (and in any accompanying resume) is true, correct, and complete to the best of my knowledge. I authorize Saginaw Transit Authority Regional Services (STARS), and/or its designee/agents, to investigate my past and present employment, education, and activities and verify all data provided to me on this application, on related papers and in interviews. I authorize and give my consent for STARS (and/or its designee/agents) to conduct reference and background checks for employment purposes. I authorize all individuals, schools, and/or firms named herein to provide any information requested about me. I release from all liability any persons, company, corporations, or educational institutions supplying such information. I release STARS (or its designee/agents) from any and all liability resulting from the verification of such information I understand that my application does not guarantee any type of employment, however, should an employment offer be extended to me and accepted, I will fully adhere to the policies, rules, and regulations of employment of STARS. I understand that, if I am hired, my employment can be terminated, with or without cause and with or without notice at any time, at the option of STARS or me. I also understand that no representative of the company has the authority to enter into any oral agreement for employment for a specified period of time or to make an oral agreement contrary to the foregoing. Subject to the terms of any collective bargaining agreement applicable to me, I agree not to commence any action or suit relating to my employment with the Employer more than 180 days after the occurrence of the facts given rise to the claim, or more than 180 days of the date of my termination of such employment, whichever is earlier, and to waive any statute of limitations to the contrary. If I am employed, I understand that additional personal data will be required for determination of benefit eligibility and for statistical purposes. I understand that if I am offered employment at STARS, I will be required to provide evidence of my identity and authorization to work in the United States. I understand that the company may require a physical examination, reference checks, background checks, and/or drug and alcohol screening as condition of employment. My signature below constitutes my understanding of the above. Signature of Applicant: Date: Application for Employment Page 5 of Johnson Street